Everything You Ever Needed to Know About OCD
From the types of OCD to its effects, supporting loved ones and further resources, here’s what you need to know about OCD.
In this article you’ll find:
My own OCD diagnosis
I clearly remember the moment my doctor diagnosed me with Obsessive Compulsive Disorder (OCD), and I find myself amused every time I recall it. Why am I amused, you ask? Well… because I laughed at him.
That’s right; my doctor diagnosed me with a serious mental illness, and I laughed at him.
There wasn’t mirth, discomfort, or even despair behind my laughter — there was just a steaming pile of ignorance. You see, up until that point, the only exposure I’d had to Obsessive Compulsive Disorder was the fictional character Melvin Udall from the film As Good as it Gets, and a 20/20 interview with Howie Mandel. OCD was supposed to be characterized by compulsive habits and a fear of germs. I just had some issues with anxiety. My doctor had to be pulling my leg.
Except… he wasn’t.
That was the day I learned that everything I thought I knew about OCD was only a fraction of a much larger whole. It was so much more than the lovable “wacky” characters in television and movies. It wasn’t just about keeping the house spotless or being particular about how things were arranged. It wasn’t cute, or funny, or fascinating. It was terrifying.
In the two years since my diagnosis, I’ve done a lot of research on Obsessive Compulsive Disorder. I know what it is, what it isn’t, and I’ve uncovered the truth behind the myths surrounding this often undiagnosed disease. For the sake of my fellow obsessive compulsives out there, I’d like to share what I’ve learned with you.
The Many Types of OCD
While this list is by no means exhaustive, generally speaking, a person with Obsessive Compulsive Disorder will have thoughts and/or behaviours that fall into one of the following five areas.
Symmetry and Orderliness
This is about the need to have everything lined up symmetrically in order to avoid feelings of anxiety or feeling uncomfortable. As an example, someone might feel a strong need to have everything neat and in its place at all times, requiring items on shelves (like canned food) to face the same way, and keeping objects free of visible marks or smudges.
People with this type of OCD spend a lot of time trying to get the symmetry ‘just right’, and the time consuming nature of this organizing can result in being late for work and appointments. Someone might also avoid having visitors to their home in an attempt to prevent symmetry and order from being disrupted. This can have a negative impact on social interaction and relationships.
Checking is a compulsive (overwhelming and compelling) response to an obsessive fear. Examples of these fears might include the fear of fire, theft or harm befalling a loved one. The thought of events like these can compel OCD sufferers to check and recheck the wellbeing of loved ones, if the oven is on, or the door locked. Whatever the fear might be, the person will find something to check to satisfy their need for reassurance.
Checking regularly results in the person being late for work, dates, and other appointments, leading to the inability to hold down jobs and relationships. Checking can also cause damage to objects that are constantly being checked.
This is the obsessive fear that something is contaminated and may cause illness or death. It often leads to a compulsion to wash and clean other things or oneself. A person who fears contamination may avoid:
- Using public toilets
- Shaking hands
- Touching door knobs and/or handles
- Eating in a public venue like a cafe or restaurant
- Touching bannisters on staircases
Cleaning or washing of the item, hands or body is carried out more than once until the person ‘feels’ clean. This takes a great deal of time and can have a serious impact on keeping jobs and relationships. There’s also a secondary physical health impact of the constant scrubbing and cleaning the skin, especially the hands.
As a subset of contamination, mental contamination shares some qualities with contact contamination, but differs in one distinctive way. The feelings of mental contamination are evoked when a person is physically or mentally abused. A sense of internal uncleanliness causes the person to carry out repetitive and compulsive attempts to wash the dirt away by bathing or showering.
This is about the inability to say goodbye to useless, worn out, or broken possessions, regardless of their actual value. The quantity of collected items sets a hoarder apart from other people. Commonly hoarded items include newspapers, cardboard boxes, household supplies, food, and clothing.
Hoarders often lack functional living space, and may also live in unhealthy or dangerous conditions. They’re willing to cope with malfunctioning appliances, electricity, and plumbing rather than allowing someone into their home to fix things.
Intrusive thoughts are where a person suffers obsessional thoughts that are repetitive, disturbing, or horrific/repugnant in nature. Because intrusive thoughts are repetitive and not voluntarily produced, they cause extreme distress. However, people with Obsessive Compulsive Disorder are the least likely to actually act on said thoughts — mostly because they find them abhorrent and go to extreme lengths to prevent them happening.
While Intrusive Thoughts can cover any subject, the more common areas of OCD related concerns fall into the following sub-categories:
Doubts over the suitability of a relationship or partner are the main focus for the obsessional thoughts. Thoughts include:
- Constantly analyzing the depth of feelings for a partner.
- Putting a partner or relationship under a microscope and fault-finding.
- Compulsively seeking approval and reassurance.
- Constant doubts about a partner’s faithfulness.
The constant questioning can place immense strain on a relationship and result in the person with OCD ending the relationship to rid themselves of the doubt and anxiety.
Sexual obsessive thoughts are about the fear of causing sexual harm, however unintended it might be. They can also relate to constantly questioning one’s own sexuality. Obsessional thoughts in this area can include:
- For of being a pedophile and being sexually attracted to children.
- Fear of being sexually attracted to family members.
- Fear of being attracted to members of the same sex – or for those who are homosexual, fear of being attracted to members of the opposite sex.
These types of intrusive thoughts cause great distress – for example, causing the person to avoid public spaces in an attempt to avoid coming into contact with vulnerable people like children. They might also avoid spending time with younger members of the family, and even their own children.
The fear is that even thinking about something bad will make it more likely to happen. Sufferers struggling with this type of intrusive thought try to dispel them with rituals that often take a lot of time to carry out. These rituals involve linking actions or events that could not possibly be related to each other.
For example, intrusive magical thinking might involve the belief that simply imagining a horrific plane crash will increase the likelihood of it happening; or a person may feel that if they don’t recite a poem every day at 10 AM sharp, their dog will die. Other examples include:
- A certain colour or number is overpoweringly associated with good or bad luck.
- Whatever comes to mind can come true.
- Without meaning to, one can cause harm to others with thoughts or carelessness.
Though the thoughts and events happening could not possibly be linked, the person with OCD will believe that this possibility does exist, resulting in severe stress and anxiety. Their silent, internal compulsive behaviours can take hours to perform, and prevent them from interacting with others.
Intrusive thoughts to do with religion are sometimes called scrupulosity. Some examples of religious intrusive thinking include:
- Fear that God will never forgive a person’s sins, and they will go to hell.
- Fear that they will have bad thoughts in a religious building.
- Fear that they will yell blasphemous words loudly in a religious place.
- Certain prayers need to be said again and again.
These thoughts place immense strain on their beliefs and prevent them from deriving peace from their religion. As a result, they may avoid church and religious practice altogether out of fear of their thoughts.
One of the most disturbing types of intrusive thoughts for people with OCD is the obsessive fear of carrying out violent acts against loved ones or other people. Intrusive thoughts include:
- Violently harming vulnerable people or loved ones.
- Acting on unwanted impulses of a violent nature.
The Effects of OCD
One of the most common side-effects of Obsessive Compulsive Disorder is avoidance of anything that might trigger it. A person with OCD often finds their obsessions and compulsions both incredibly frightening, and mentally and physically draining. To prevent hours of obsessive compulsive behaviour, they’re likely to go to great lengths to avoid the triggers that prompt it.
Since their trigger may be a physical object, person, place, or internal thought, avoidance will no doubt have a substantial impact on their quality of life. Health, employment, and relationships can all suffer, which only serves to further their suffering. Furthermore, individuals who suffer from OCD sometimes turn to drugs and alcohol as a way to cope with overwhelming anxiety and fear.
Supporting Loved Ones With OCD
To both sufferers and non-sufferers, the thoughts and fears related to OCD are profoundly shocking. However, they are just thoughts, not fantasies or impulses which will be acted upon.
Supporting a loved one with OCD isn’t always easy, but it is both needed and appreciated. Here are some things you can do to help friends and family members with Obsessive Compulsive Disorder:
- Encourage Your Loved One to Seek Professional Help
OCD is a complex condition that often requires professional help in the form of both therapy and medications. By encouraging your loved one to seek help, you can play a large role in assisting them on the road to recovery.
- Modify Your Expectations
It is often during times of change (even positive change) that symptoms tend to flare up. You can help lessen stress by modifying your expectations during these times of transition. Conflict of any kind will only fuel the fire and escalate symptoms.
- Avoid Enabling Compulsions
While some behaviours reduce anxiety, they may also enable the cycle of OCD to continue. Though it may be tempting to allow rituals to continue in order to avoid stress, by accommodating your loved one in these ways you are perpetuating the cycle of fear, obsession, anxiety, and compulsion.
- Celebrate Small Accomplishments
Accomplishing even the smallest of things, like resisting the need to ask for reassurance one more time, is a big step for someone with OCD. While these gains may seem insignificant to you, acknowledging these seemingly small accomplishments encourages them to keep trying. Knowing that their hard work to get better is being recognized can be a powerful motivator.
- Don’t Criticize
Avoid personal criticism. OCD can be irritating, but always remember that the person who dislikes the situation the most is the person who has OCD. They already feel inferior to others, and adding to this pressure will do no good at all.
- Offer a Distraction
Help distract your loved one from their thoughts when they’re faced with the urge to engage in compulsive behaviour. You can help by offering a distraction like going for a walk, or listening to music.
- Take Care of Yourself
You can’t help someone else if your aren’t taking care of yourself. Give yourself some time away from your loved one in order to relax. It’s also helpful to join a support group. Groups for people who have loved ones with mental health disorders can provide you with support for your frustrations, and a safe place to vent.
Obsessive Compulsive Disorder can be terrifying for those who suffer from it. By understanding what drives their behaviour, how it affects their lives, and supporting their endeavors to get better, you can be a positive force for change in their lives.
Mental Health Resources for Obsessive Compulsive Disorder
For more information on topics discussed in this article, please see the following resources:
- 4 Myths About OCD
- Effects of OCD: Living with OCD
- How to Help Your Child: A Parent’s Guide to OCD
- OCD and Substance Abuse
- Support Groups for OCD (international)
- UK OCD support groups (via OCD UK)